The choice of treatment depends mainly on how advanced your disease is and whether or not you have symptoms. If you have multiple myeloma without symptoms, you may not need cancer treatment right away. In that case, you may have what is called smoldering myeloma, and your doctor will monitor your health closely so treatment can start if symptoms develop.
If you already have symptoms (CRAB criteria) or markers that indicate a high risk for progression (specific blood, imaging and bone marrow results) your treatment plan will likely include an approach called standard therapy, which uses a combination of medicines to cause remission, reducing the cancer cells in your body significantly.
Most patients ultimately receive several treatment approaches, which may involve one or more of the following:
- Standard therapy for multiple myeloma refers to a combination of three to four different medicines, which may include chemotherapy, immunotherapy, proteasome inhibitors, monoclonal antibodies, steroids and others.
- Stem cell or bone marrow transplant (BMT) to recover bone marrow after high dose chemotherapy.
- Cellular therapy that takes cancer-killing T-cells from the patient improves them in a laboratory and infuses them back into the patient to fight the cancer.
- Clinical trials to access the very latest options, years before they become available from other providers.
- Quality of life treatments to address bone damage, neuropathy, pain and other symptoms.
The Myeloma team at Roswell Park follows the Clinical Practice Guidelines in Oncology™ developed by the National Comprehensive Cancer Network (NCCN). Jens Hillengass, MD, PhD, our Chief of Myeloma, serves on the NCCN panel of experts that develops the guidelines, which are internationally recognized standards for treating cancer patients. He also is a member of the International Myeloma Working Group, which develops guidelines for the diagnosis and treatment of myeloma and related diseases.